Amelioration of Diabetes Mellitus Type II after Sleeve Gastrectomy—Data on Nationwide Survey on Quality Assurance in Bariatric Surgery in Germany
- 1 Sachsenhausen Hospital, Frankfurt, Germany
- 2 Sachsenhausen Hospital, Frankfurt, Germany
- 3 Helios Hospital, Bad Saarow, Germany
- 4 Department of General, Abdominal and Vascular Surgery, University Hospital Magdeburg, Magdeburg, Germany
- 5 Stat Consult, Magdeburg, Germany
- 6 Department of General, Abdominal and Paediatric Surgery, SRH Hospital, Gera, Germany
- 7 Department of General, Abdominal and Paediatric Surgery, SRH Hospital, Gera, Germany
Abstract
Introduction: Sleeve Gastrectomy (SG) is becoming more popular due to its weight reducing effect and promising anti-diabetic efficacy. However, long term results are still lacking. Methods: The study focuses on anti-diabetic efficacy of SG through retrospective analysis of data for patients who underwent SG in Germany from 2005 to 2011. Anti-diabetic efficacy was assessed at 1, 2 and up to 4 years after surgery. Results: 5400 morbidly obese patients underwent SG. Of these 5400 patients 13.2% (n = 712) were insulin treated (IT) and 21.6% (n = 1165) were non-insulin treated (NIT). Total follow - up was accomplished in 41.24% of patients. Percentage of remission and improvement (RI) at 1 year was 83.8% (80.2% for insulin treated (IT) vs. 85.1% for non-insulin treated (NIT)). RI% at 2 years dropped to 77.6% (76.9% for IT vs. 77.9% for NIT patients). With late follow up (up to 4 years), RI% was 65.9% (58.8% for IT vs. 66.7% for NIT patients). Difference between IT and NIT patients was insignificant. Conclusion: SG shows promising ant-diabetic efficacy at 1 year, 2 years and up to 4 years after surgery. This efficacy gradually drops with prolonged time interval after surgery and seems to be insignificantly higher among NIT vs. IT patients.
- G. Almogy, P. F. Crookes and G. J. Anthone, “Longitudinal Gastrectomy as a Treatment for the High-Risk Super-Obese Patient,” Obesity Surgery, Vol. 14, No. 4, 2004, pp. 492-497. http://dx.doi.org/ 10.1381/096089204323013479
- M. Deitel, R. D. Crosby and M. Gagner, “The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25-27, 2007,” Obesity Surgery, Vol. 18, No. 5, 2008, pp. 487-496. http://dx.doi.org/10.1007/s11695-008-9471-5
- M. Gagner, M. Deitel, T. L. Kalberer, et al., “The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009,” Surgery for Obesity and Related Diseases, Vol. 5, No. 4, 2009, pp. 476-485.
- M. Daskalakis and R. A. Weiner, “Sleeve Gastrectomy as a Single-Stage Bariatric Operation: Indications and Limitations,” Obesity Facts, Vol. 2, No. S1, 2009, pp. 8-10. http://dx.doi.org/10.1159/ 000198239
- C. Stroh, R. Weiner, T. Horbach, K. Adipositas, A. Adipositaschirurgie, et al., “New Data on Quality Assurance in Bariatric Surgery in Germany,” Zentralblatta fur Chirurgie, Vol. 138, No. 2, 2013, pp. 180-188.
- “NIH Conference Gastrointestinal Surgery for Severe Obesity. Consensus Development Conference Panel,” Annals of Internal Medicine, Vol. 115, 1991, pp. 956-961.
- American Diabetes Association, “ADA Standards of Medical Care in Diabetes—2009,” Diabetes Care, Vol. 32, No. S1, 2009, pp. S13-S61.
- J. B. Buse, S. Caprio, W. T. Cefalu, et al., “How Do We Define Cure of Diabetes?” Diabetes Care, Vol. 32, No. 11, 2009, pp. 2133-2135.
- F. X. Pi-Sunyer, “The Effects of Pharmacologic Agents for T2DM on Body Weight,” Postgraduate Medicine, Vol. 120, 2008, pp. 5-17. http://dx.doi.org/10.3810/pgm.2008.07.1785
- B. R. Smith, P. Schauer and N. T. Nguyen, “Surgical Approaches to the Treatment of Obesity: Bariatric Surgery,” Endocrinology and Metabolism Clinics of North America, Vol. 37, No. 4, 2008, pp. 943-964. http://dx.doi.org/10.1016/j.ecl.2008.08.001
- J. S. Todkar, S. S. Shah, P. S. Shah and J. Gangwani, “Long-Term Effects of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Subjects with Type 2 Diabetes Mellitus,” Surgery for Obesity and Related Diseases, Vol. 6, No. 2, 2010, pp. 142-145. http://dx.doi.org/10.1016/j.soard.2009.06.008
- M. Dietel, M. Ganger, A. L. Erickson and R. D. Crosby, “Third International Summit: Current Status of Sleeve Gastrectomy,” Surgery for Obesity and Related Diseases, Vol. 7, No. 6, 2012, pp. 749-759.